Biomedical subjects
Publications and source records attributed to A Nicolai.
We report a case of acute transient encephalopathy with confusion, drowsiness, myoclonic jerks, periodic triphasic sharp wave EEG patterns induced by low doses of baclofen. We discuss the pathogenesis and the differential diagnosis from the subacute spongiform encephalopathy of sudden onset.
Clinical features of anterior choroidal artery (ACA) territory infarct are hemiplegia, hemi-anaesthesia and homonymous hemianopia. However this syndrome in its complete form is of rare occurrence, since one or more signs or symptoms may be lacking. The Authors describe 11 patients with CT-documented infarctions in the (ACA) territory in order to establish clinical-CT correlations and possible risk factors. Among the investigated risk factors arterial hypertension is the most frequent in these patients. This finding, and the small size of the ischemic lesions make the ACA territory infarctions similar to Lacunar Infarcts. The Authors, emphasize that, as in lacunar infarcts, a thromboembolic mechanism cannot always be ruled out in ACA infarctions. Therefore a cause other than arterial hypertension should be considered in each patient for a better management of this type of infarcts.
The authors report the case of a 32-year-old woman who developed symptoms and signs possible manifestations of a familial motor neuron disease with left sided pyramidal signs and marked wasting and weakness in the ipsilateral upper girdle, progressively extended to the contralateral upper limb. The CT-scan showed only frontal cortical atrophy. MRI disclosed a restricted area of increased signal intensity in the centrum semiovale of the subcortical white matter of the right prefrontal cortex. This young woman did not disclose any risk factors for cerebrovascular diseases nor other disorders of the CNS; therefore the authors are of the opinion that the white matter changes observed on MRI are not occasional findings, but are related to the pathologic process occurring in consequence of her neurodegenerative disorder (possible ALS).
Two groups of 24 healthy caucasian women, similar with regard to age classes (from 19 to 55) as well as fair and dark complexion of skin and hair, volunteered to use during a 14-day span a conventional facial cream (active placebo: AP) and thereafter, during a 21-day span Noctosome (Noctos). The latter is a new generation of liposome made with non-ionic lipids leading to microspheres which include glycopeptides in the aqueous compartment of the vesicle, alpha-tocopherol ester in the membrane-like structure and sphingo-ceramides at the surface of the microspheres. The aim of the study was to test the beneficial effects of Noctos (vsAP) with respectively morning (7-9-hr) and evening (21-23-hr) applications as facial ointments. Observed differences were validated using several statistical tests: ANOVA, cosinor, etc. Subjects were socially synchronized with a diurnal activity from 7 hr to 23 hr and a nocturnal rest. Each day, at fixed clock hours (7, 10, 20 and 23 hr), each subject used visual analogue scales to self-rate a set of variables characterizing facial aspects. Brilliance of complexion and texture of skin exhibited a circadian rhythm (peak time at 10 hr), both with AP and Noctos. The latter produces a beneficial effect with regard to reference values (AP). The evening application of Noctos is more efficient than the morning one. However, the magnitude of this beneficial effect is related both to age (greater for the age class 25-35 years than for younger and older subjects) and to skin complexion (greater for fair than dark complexioned subjects). Major beneficial effects of Noctos in the evening hours are related neither to fatigue nor to mood of the women since the respective circadian rhythms of these variables appear to vary independently from those of facial skin characteristics.
We studied 80 patients with lacunar strokes in the attempt to find a relation between lacunar strokes, arterial hypertension and leucoaraiosis. Leucoaraiosis was found in 47 patients (58,75%) on CT-scan. Our findings emphasize that arterial hypertension is the most important risk factor of leucoaraiosis (p less than 0.003); but we did not find a relation between the admission value of systolic or diastolic blood pressure and leucoaraiosis. Our data do not confirm the hypothesis that leucoaraiosis may be the result of a confluence of several lacunar infarcts, although we found that a rarefaction of cerebral white matter was associated with arterial hypertension.
We describe a case of a cavernous angioma of the right thalamus, identified by MRI, showing transient vertical diplopia in the upward gaze, present only in protracted recumbency. We consider possible pathogenetic mechanisms in an attempt to explain this peculiar disturbances. In addition we emphasize that MRI is the most sensitive procedure for detection of the cavernous angioma.
The authors describe the case of a patient showing a lateralized and subacute parkinsonism with CT-evidence of a single lacunar infarct in the contralateral basal ganglia. The vascular origin of this type of subacute parkinsonism is emphasized.
We describe the case of a right-handed, 83 year-old woman with CT-documented left frontal subacute subdural hematoma showing reversible right-sided hemiparesis and aphasia. We discuss possible pathogenetic mechanism for this unusual condition and emphasize that the clinical evaluation cannot always distinguish ischemic causes for certain. Therefore CT-scan is an essential investigative tool before initiating therapy in patients suspected of having cerebrovascular diseases.
A case of intramedullary spinal cord metastasis is reported in which the diagnosis was possible through intrathecal contrast medium computerized tomography. The case described suggests that this method of radiologic investigation can provide a prompt identification of ISM from other noncompressive complications of systemic cancers. This is very important for radiation treatment which can be effective in the early stages of ISM.
A retrospective analysis was carried out on 52 patients with CT-identified lacunar infarcts in order to identify possible risk factors. It was found that arterial hypertension, cardiac emboli and/or emboli from epiaortic vessels play a significant role in the genesis of lacunar infarcts. No preferential relationship was found between "small" lacunes and arterial hypertension or between "large" lacunes and embolic disease.
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We describe the case of a patient with a history of resistant asthma who presented with subacute neuropathy, hypereosiniphilia and central nervous system involvement; these findings were consistent with allergic granulomatous angiitis (Churg-Strauss syndrome). Although cutaneous biopsy prompted the diagnosis, the cases reported suggests that clinical, biological and histological data are all essential for the diagnosis. We emphasize that an early recognition of this syndrome may be important, since appropriate therapy may lead to recovery or influence favorably at least long term survival.
We examined a 55-year-old right-handed woman showing transient coma, amnesia, mild right hemiparesis, vertical gaze impairment and aphonia without aphasia. CT-scanning revealed bilateral paramedian thalamic infarction in the territory of the thalamo-subthalamic paramedian arteries. Aphonia may occur as a consequence of thalamic lesions, but until now it has not been described as an isolated speech disturbance.
Three right-handed subjects presented impairment of consciousness, paralysis of vertical gaze, aphasia and memory disturbances. Computed tomography scans showed low-density lesions in the paramedian areas of the left thalamus. Neuropsychological examination revealed a fluent aphasia in one patient and a nonfluent in two; all had paraphasias and perseveration. Comprehension, repetition and writing were normal. In the literature on so-called thalamic aphasia only a few cases are reported with involvement of the paramedian nuclear complex.
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Potentials of single cells of the dorsal lateral geniculate nucleus (dLGN) were recorded extracellularly in albino rats by means of micropipettes filled with trypan blue for iontophoretic marking of tip localization. The cells were grouped concerning their response latencies to photic stimuli, their response patterns, and their localization within the dLGN. It could be shown in a conditioning paradigm that combination of light with electrical tail stimulation resulted in temporary response changes of "fast" OFF-cells which are mainly localized in the rostroventromedial part of dLGN. "Fast" ON-cells had mainly stable response patterns to light. Changes which persisted after the end of tail stimulation trials occurred in "slow" oN- and oFF-cells located in the dorsolateral and caudal part of dLGN.
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